title: Femorodistal bypass using the chemically processed human umbilical vein graft: 9-year experience.
abstract: To evaluate patency, limb salvage rates and complications associated with the use of human umbilical vein as an arterial substitute, the authors carried out a retrospective review of 52 femorodistal bypasses performed over 9 years using human umbilical vein. Indications for operation included acute ischemia, rest pain and nonhealing ulceration or gangrene. There were 28 early occlusions, which resulted in a 1-month primary patency rate of 46% and a secondary patency rate of 52%. The primary and secondary patency rates at 1 year were 18% and 19% respectively. The mean limb salvage rate at 1 month was 57% and at 1 year 34%. Three aneurysms occurred (two anastomotic, one graft). Factors found to have a significant effect on patency rates were indication for operation and state of distal runoff. Infection occurred in 6% of grafts and led to amputation in every case. These disappointing results have caused the authors to discontinue use of human umbilical vein as an arterial substitute.
authors.affiliation: Department of Surgery, Hôpital Annexe-République, Centre Hospitalier Universitaire de Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Batt
authors.forename: G
authors.initials: G
authors.lastname: Avril
authors.forename: J M
authors.initials: JM
authors.lastname: Gagliardi
authors.forename: R
authors.initials: R
authors.lastname: Guzman
authors.forename: R
authors.initials: R
authors.lastname: Guidoin
authors.forename: N
authors.initials: N
authors.lastname: Boas
authors.forename: B
authors.initials: B
authors.lastname: Daune
authors.forename: R
authors.initials: R
authors.lastname: Hassen-Khodja
authors.forename: P
authors.initials: P
authors.lastname: Le Bas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001705:Bioprosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014471:Umbilical Veins / Q000637:transplantation*; D014654:Vascular Patency